The evolving role of the primary care provider in the comprehensive cancer care paradigm: Knowledge, attitudes, beliefs, and practices of primary care clinicians.

Abstract

28 Background: Due to increasing numbers of individuals diagnosed with cancer, a burgeoning cohort of cancer survivors with significant medical co-morbidities, and oncology workforce challenges, the optimal integration of Primary Care Providers (PCPs) into the comprehensive cancer care paradigm is of timely importance. The goal of this investigation is to determine the knowledge, attitudes, beliefs, and practices of primary care clinicians -- pertaining to their existing and potential roles in cancer care. Methods: 1,069 clinical affiliates of the University of Pittsburgh Medical Center, who provide primary care services (e.g. Cardiology, Family Medicine, Geriatric Medicine, Gynecology, and Internal Medicine), were invited to participate in a 77-question, IRB-approved, online survey questionnaire [Qualtrics (Provo, Utah)]. Three “reminder emails” were generated. Results: Note: These results reflect the analysis of an initial, preliminary subset of survey responders (N=90). The full data set will be utilized for the final poster presentation. Eighty percent of the responders are physicians. Seventy-one percent reported that 50%+ of their time is spent providing primary care services and 66% have been in-practice for 15+ years. 73%, 63% and 59% respectively have participated in “cancer surveillance”, “cancer treatment/disease-related adverse event (AE) monitoring”, and “AE management” activities. Cardiotoxicity (42%), lymphedema (61%), and vasomotor flushing (63%) represented those AEs that the responders felt least comfortable monitoring independently. Twelve percent were aware of the PCP-targeted December/2015 “ACS-ASCO Breast Cancer Guideline” and 24% of the term “Survivorship Care Plan”. Twenty-two percent were “very confident” with regard to conducting a “low dose CT” lung cancer screening decision-making patient conversation. Twenty-one percent felt that their formal training did not adequately prepare them and that their present educational opportunities are inadequate pertaining to PCP-Cancer Survivorship issues. “Communication between the Oncology Team and PCP” was noted as the most stated “major issue”. Conclusions: To fully optimize the interface between Oncologists and PCPs with regard to best practices cancer care, strategies targeting competency training, enhanced information/guideline dissemination, and the development of collaborative-based delivery models will likely be necessary.